Alignment Techniques in Total Knee Arthroplasty：Where do We Stand Today?
Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral post-operative joint alignment. However, contemporary approaches, such as kinematic a...
Saved in:
| Published in: | Chinese medical sciences journal Vol. 39; no. 3; p. 217 |
|---|---|
| Main Authors: | , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
China
01.09.2024
|
| Subjects: | |
| ISSN: | 1001-9294 |
| Online Access: | Get more information |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral post-operative joint alignment. However, contemporary approaches, such as kinematic alignments and hybrid techniques including adjusted mechanical, restricted kinematic, inverse kinematic, and functional alignments, are gaining attention for their ability to restore native joint kinematics and anatomical alignment, potentially leading to enhanced functional outcomes and greater patient satisfaction. The ongoing debate on optimal alignment strategies considers the following factors: long-term implant durability, functional improvement, and resolution of individual anatomical variations. Furthermore, advancements of computer-navigated and robotic-assisted surgery has augmented the precision in implant positioning and objective measurements of soft tissue balance. Despite ongoing debates on balancing implant longevity and functional outcomes, there is an increasing advocacy for personalized alignment strategies that are tailored to individual anatomical variations. This review evaluates the spectrum of various alignment techniques in TKA, including mechanical alignment, patient-specific kinematic approaches, and emerging hybrid methods. Each technique is scrutinized based on its fundamental principles, procedural techniques, inherent advantages, and potential limitations, while identifying significant clinical gaps that underscore the need for further investigation. |
|---|---|
| AbstractList | Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral post-operative joint alignment. However, contemporary approaches, such as kinematic alignments and hybrid techniques including adjusted mechanical, restricted kinematic, inverse kinematic, and functional alignments, are gaining attention for their ability to restore native joint kinematics and anatomical alignment, potentially leading to enhanced functional outcomes and greater patient satisfaction. The ongoing debate on optimal alignment strategies considers the following factors: long-term implant durability, functional improvement, and resolution of individual anatomical variations. Furthermore, advancements of computer-navigated and robotic-assisted surgery have augmented the precision in implant positioning and objective measurements of soft tissue balance. Despite ongoing debates on balancing implant longevity and functional outcomes, there is an increasing advocacy for personalized alignment strategies that are tailored to individual anatomical variations. This review evaluates the spectrum of various alignment techniques in TKA, including mechanical alignment, patient-specific kinematic approaches, and emerging hybrid methods. Each technique is scrutinized based on its fundamental principles, procedural techniques, inherent advantages, and potential limitations, while identifying significant clinical gaps that underscore the need for further investigation.Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral post-operative joint alignment. However, contemporary approaches, such as kinematic alignments and hybrid techniques including adjusted mechanical, restricted kinematic, inverse kinematic, and functional alignments, are gaining attention for their ability to restore native joint kinematics and anatomical alignment, potentially leading to enhanced functional outcomes and greater patient satisfaction. The ongoing debate on optimal alignment strategies considers the following factors: long-term implant durability, functional improvement, and resolution of individual anatomical variations. Furthermore, advancements of computer-navigated and robotic-assisted surgery have augmented the precision in implant positioning and objective measurements of soft tissue balance. Despite ongoing debates on balancing implant longevity and functional outcomes, there is an increasing advocacy for personalized alignment strategies that are tailored to individual anatomical variations. This review evaluates the spectrum of various alignment techniques in TKA, including mechanical alignment, patient-specific kinematic approaches, and emerging hybrid methods. Each technique is scrutinized based on its fundamental principles, procedural techniques, inherent advantages, and potential limitations, while identifying significant clinical gaps that underscore the need for further investigation. Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral post-operative joint alignment. However, contemporary approaches, such as kinematic alignments and hybrid techniques including adjusted mechanical, restricted kinematic, inverse kinematic, and functional alignments, are gaining attention for their ability to restore native joint kinematics and anatomical alignment, potentially leading to enhanced functional outcomes and greater patient satisfaction. The ongoing debate on optimal alignment strategies considers the following factors: long-term implant durability, functional improvement, and resolution of individual anatomical variations. Furthermore, advancements of computer-navigated and robotic-assisted surgery has augmented the precision in implant positioning and objective measurements of soft tissue balance. Despite ongoing debates on balancing implant longevity and functional outcomes, there is an increasing advocacy for personalized alignment strategies that are tailored to individual anatomical variations. This review evaluates the spectrum of various alignment techniques in TKA, including mechanical alignment, patient-specific kinematic approaches, and emerging hybrid methods. Each technique is scrutinized based on its fundamental principles, procedural techniques, inherent advantages, and potential limitations, while identifying significant clinical gaps that underscore the need for further investigation. |
| Author | Meghal, Goyal Hemanta, Dhungana Subhash, Jangid |
| Author_xml | – sequence: 1 givenname: Dhungana surname: Hemanta fullname: Hemanta, Dhungana organization: Department of Orthopedics, Fortis Hospital, Gurgaon, Haryana, India – sequence: 2 givenname: Jangid surname: Subhash fullname: Subhash, Jangid organization: Department of Orthopedics, Fortis Hospital, Gurgaon, Haryana, India – sequence: 3 givenname: Goyal surname: Meghal fullname: Meghal, Goyal organization: Department of Orthopedics, Fortis Hospital, Gurgaon, Haryana, India |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39099407$$D View this record in MEDLINE/PubMed |
| BookMark | eNo1kEtOwzAURT0ooh8QO0AeMgk8O_7EI1RV_CsxoKjDyImfaVDilDgZdCushT2xBYooozs5ujr3TskotAEJOWNwyYXhcAUgUs1HZMIAWGK4EWMyjfEdABTLxDEZpwaMEaAn5HFeV2-hwdDTFZabUH0MGGkV6KrtbU2fAiKdd_2ma7e1jf3u--tzvcEOqWvpGulLb4Pbs87urk_Ikbd1xNNDzsjr7c1qcZ8sn-8eFvNlUnLNeOJlIdAp7p0CKwufFdyzgmEKSnEmnQArUu4x05qVSirluTaZLlPBtBfc8hm5-Ovddu2vbZ83VSyxrm3Adoh5ClkmpWT7L2bk_IAORYMu33ZVY7td_r-f_wAAJ1pU |
| CitedBy_id | crossref_primary_10_1186_s13018_025_05709_z crossref_primary_10_1002_ksa_12557 |
| ContentType | Journal Article |
| DBID | NPM 7X8 |
| DOI | 10.24920/004372 |
| DatabaseName | PubMed MEDLINE - Academic |
| DatabaseTitle | PubMed MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic PubMed |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine Biology Pharmacy, Therapeutics, & Pharmacology |
| ExternalDocumentID | 39099407 |
| Genre | Journal Article |
| GroupedDBID | --- -05 -0E -SE -S~ .~1 0R~ 1B1 1~. 1~5 29B 4.4 457 4G. 53G 5GY 5VR 7-5 71M 92F 92I 92M 9D9 9DE AAEDT AALRI AAXDM AAXUO ABBQC ABKZE AEKER AFTJW AGYEJ AJRQY ALMA_UNASSIGNED_HOLDINGS CAJEE CCEZO CHBEP CIEJG CW9 DU5 EBS EP2 EP3 FA0 FDB FNPLU GBLVA J1W JUIAU M41 MO0 N9A NPM O-L O9- P-8 P-9 PC. Q-- Q-4 Q38 R-E ROL RT5 S.. SDF SES T8U TCJ TGQ U1F U1G U5E U5O WFFXF 5XA 5XF 7X8 AIGII ~HD |
| ID | FETCH-LOGICAL-c2712-f5b4ed62fd60a5bf8b2f1b1e3066215d40a432fe8771c6566f27987c3417f42a2 |
| IEDL.DBID | 7X8 |
| ISSN | 1001-9294 |
| IngestDate | Sat Sep 27 23:38:27 EDT 2025 Wed Feb 19 02:14:31 EST 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 3 |
| Keywords | total knee arthroplasty mechanical alignment functional alignment hybrid alignment anatomical alignment alignment axes kinematic alignment |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c2712-f5b4ed62fd60a5bf8b2f1b1e3066215d40a432fe8771c6566f27987c3417f42a2 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 |
| OpenAccessLink | https://doi.org/10.24920/004372 |
| PMID | 39099407 |
| PQID | 3088555149 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_3088555149 pubmed_primary_39099407 |
| PublicationCentury | 2000 |
| PublicationDate | 2024-09-01 |
| PublicationDateYYYYMMDD | 2024-09-01 |
| PublicationDate_xml | – month: 09 year: 2024 text: 2024-09-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | China |
| PublicationPlace_xml | – name: China |
| PublicationTitle | Chinese medical sciences journal |
| PublicationTitleAlternate | Chin Med Sci J |
| PublicationYear | 2024 |
| SSID | ssj0006184 |
| Score | 2.3171747 |
| SecondaryResourceType | review_article |
| Snippet | Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally,... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 217 |
| Title | Alignment Techniques in Total Knee Arthroplasty：Where do We Stand Today? |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/39099407 https://www.proquest.com/docview/3088555149 |
| Volume | 39 |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LS8NAEB7UqnjxUV_1xQrSk8Fks-lmvZQiFkVaeojYW9lNdqUgSW2q0H_vbJKSkyB4yW1J2MzOfLMz830AN8yIWPnC2BFlhQlKKBxJFXMw1rucukobXopN8OEwHI_FqLpwy6u2ypVPLBx1ksX2jvzOx-MQ2PAuurNPx6pG2epqJaGxDg0foYy1aj6u2cKtmElR7cSUGWEAq4ZmmaBuSepDf8eVRXzp7_33y_Zht0KWpFeawgGs6bQJW6XW5LIJ24Oqit6E9qjkq17ekqgev8pvSZuMaibr5SE89z6m70W7AIlWXK85maYkyhCzk5dUa_s-q7SAIHyxvCfo2-eaJBl508QKFCek6NPpHsFr_zF6eHIq7QUnptyjjgkU00mHmqTjykCZUFHjKU_7ljHeCxLmSuZTo0POvdhiQkO5CHmMQZEbRiU9ho00S_UpkFhiRGSBqxhXuExJQ4UMPalD32iqaAuuV_s6Qdu2BQuZ6uwrn9Q724KT8udMZiUJx8QXiG0xGz37w-pz2KGIRcrWsAtoGDzZ-hI24-_FNJ9fFUaDz-Fo8AM-0Mpq |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Alignment+Techniques+in+Total+Knee+Arthroplasty%EF%BC%9AWhere+do+We+Stand+Today%3F&rft.jtitle=Chinese+medical+sciences+journal&rft.au=Hemanta%2C+Dhungana&rft.au=Subhash%2C+Jangid&rft.au=Meghal%2C+Goyal&rft.date=2024-09-01&rft.issn=1001-9294&rft_id=info:doi/10.24920%2F004372&rft_id=info%3Apmid%2F39099407&rft_id=info%3Apmid%2F39099407&rft.externalDocID=39099407 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1001-9294&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1001-9294&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1001-9294&client=summon |